You can be sued for failing to do the SRP. They cannot legally decline perio tx and you just go ahead and do a prophy or a gross scale and that's it. I know personally, I was called on behalf of the pt, that when a pt signs consent not to pay for perio it won't hold water. They don't have the knowledge or education to know the long term ramifications of their decision. Now that perio is tied to heart disease, diabetes, and other health conditions you'd better be careful on that one. And it won't matter if the dr tells you to go ahead. If that pt sues, you're supposed to know better. Everyone in the practice can be named in the suit. Many times I've told a pt I cannot see them because to not treat the perio is not optimal quality care, that it would be negligent on my part to do so. I've done SRP and not charged when it's only a couple of teeth and many times gone below the gumline for a regular prophy fee. I like to do a FMD if there is a lot of swelling or bleeding. It gives the tissues a chance to heal and toughen up so I can do what I need to without hurting the pt. But always tell your pt that they must return for the prophy, that you haven't finished. Good Luck.